- Highmark Health (Buffalo, NY)
- …Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses ... and then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- HCA Healthcare (Kansas City, MO)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... 156,000 hours volunteering in our communities. As a Mental Health Professional III Licensed with Research Psychiatric Center you...in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with… more
- Veterans Affairs, Veterans Health Administration (Columbia, SC)
- …vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Complete all application requirements detailed in the ... the patient. ii. Knowledge to interpret and apply all health and safety regulations, to minimize and mitigate risks...care; develop and select interventions to achieve patient goals; review patient progress; adapt or adjust the treatment plan… more
- Ascension Health (Racine, WI)
- …areas of responsibility, to include but not limited to; + Quality and Safety + Utilization Review + Peer Review and Credentialing + Growth and Strategic ... conduct. Ensures adherence and completion of medical staff decisions regarding peer review and physician behavioral issues. + Leads the development of… more
- BrightSpring Health Services (Dunbar, WV)
- …submit to State Health Services Director and Assigned Director, Clinical Practice* Review utilization report at least monthly to ensure adequate hours on ... community living, adult host homes for adults regardless of disability, behavioral /mental health support, in-home pharmacy solutions, telecare and remote… more
- New York State Civil Service (Valatie, NY)
- …experimental psychology, research psychology, industrial psychology, organizational psychology, utilization review , guidance counseling, etc. Additional Comments ... homes, as well as discipline-specific projects, including assisting with enhancing utilization of electronic health records, participation in relevant committees… more
- Highmark Health (Little Rock, AR)
- …of the claim rejection and the proper action to complete the retrospective claim review with the goal of proper and timely payment to provider and member ... Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a ...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- CenterWell (Nashville, TN)
- …short-term interventions, and connection to community-based resources. This role brings behavioral health expertise and addresses social determinants of ... of an interdisciplinary team-particularly in partnership with primary care teams, community health workers, pharmacists, and behavioral health specialists.… more
- New York State Civil Service (NY)
- …in experimental psychology, research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance ... With Developmental Disabilities, Office for Title Psychologist 1/2 Occupational Category Health Care, Human/Social Services Salary Grade 21 Bargaining Unit PS&T -… more
- WellSpan Health (Lebanon, PA)
- …providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. ... between visits. + Assists in the management of patient utilization of health care system and provides...care through our extensive WellSpan primary, specialty, ambulatory, and behavioral health care locations within the community.… more